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目的探讨分析磁共振弥散加权成像(DWI)在临床预测宫颈癌放射敏感性中的应用价值。方法选取2012年1月-2014年12月在该院肿瘤科接受治疗的50例经单纯放疗被初步诊断为宫颈癌的患者为研究对象,于患者行常规外照射前、外照射20GY/10F时及完成外照射时3个时间点对所有患者进行1.5T磁共振常规序列扫描和磁共振DWI扫描。图像处理后,对各时点的宫颈癌原发灶ADC值进行测量,并分析各时点的差异性及其与肿瘤退缩率的相关性。结果行常规外照射前、外照射20GY/10F时及完成外照射时3个时间点的宫颈癌原发灶ADC值分别为(0.82±0.14)×10~(-3)mm~2/s、(1.14±0.17)×10~(-3)mm~2/s、(1.44±0.13)×10~(-3)mm~2/s,两两之间比较,差异均有统计学意义(均P<0.05);行常规外照射之前和外照射20GY/10F时及完成外照射时3个时间点的宫颈癌原发灶ADC值与肿瘤退缩率均不存在统计学意义(均P>0.05),而行常规外照射之前和外照射20GY/10F时2个时间点宫颈癌原发灶ADC值的R值与肿瘤退缩率呈明显正相关关系(r=0.423,P=0.024)。结论放疗后,宫颈癌原发灶ADC值随着外照射剂量的逐渐增加呈现出进行性升高的趋势,且ADC值的早期变化与肿瘤退缩率呈明显的正相关性,可作为预测宫颈癌放射敏感性的重要指标。磁共振DWI技术作为一种非侵入技术,在放疗早期预测肿瘤放射敏感性中具有广阔的应用前景,并在实用性和经济学等其他方面具有较高的研究价值。
Objective To investigate the value of magnetic resonance diffusion-weighted imaging (DWI) in the clinical prediction of radiosensitivity of cervical cancer. Methods From January 2012 to December 2014, 50 patients undergoing primary radiotherapy in cervical cancer treated by oncology department of our hospital were selected as study subjects. Before external routine irradiation and 20GY / 10F external beam irradiation All patients underwent 1.5T magnetic resonance conventional sequence scan and magnetic resonance DWI scan at 3 time points when external irradiation was completed. After the image processing, the ADC value of primary cervical cancer at each time point was measured, and the difference of each time point and its correlation with tumor shrinkage rate were analyzed. Results The ADC values of primary cervical cancer before and after external beam irradiation at 20 Gy / 10 F and external beam irradiation were 0.82 ± 0.14 × 10 -3 mm 2 / s, (1.14 ± 0.17) × 10 ~ (-3) mm ~ 2 / s and (1.44 ± 0.13) × 10 ~ (-3) mm ~ 2 / s, respectively.The differences between the two groups were statistically significant P <0.05). There were no significant differences in ADC value and tumor shrinkage rate of cervical cancer before and after routine external irradiation (20GY / 10F) and external irradiation (3P> 0.05) (R = 0.423, P = 0.024). However, there was a positive correlation between the R value of ADC value and the tumor shrinkage rate at two time points before and after external routine irradiation (20GY / 10F). Conclusion After radiotherapy, the ADC value of primary cervical cancer shows a progressive increase with the increase of external dose, and the early change of ADC value has a positive correlation with the tumor shrinkage rate, which can be used as a prediction of cervical cancer An important indicator of radiosensitivity. As a noninvasive technique, magnetic resonance DWI has broad application prospects in predicting tumor radiosensitivity in the early stage of radiotherapy and has high research value in practicality and economics.